The study explores institutionalization of commercial surrogacy exchange
in India. Surrogacy is defined as “an
arrangement in which a woman agrees to a pregnancy achieved through Assisted
Reproductive Technology (ART), in which neither of the gametes belongs to her
or her husband, with the intention to carry it and hand over the child to the
person or persons for whom she is acting as a surrogate.” In commercial
surrogacy surrogates receive commercial gains in-lieu of the services they
provide. We argue that exchange institutionalization is a market creation since
markets are ‘socially constructed structured exchanges’ (Fligstein, 1996,
Humphrey, 2010). The institutionalization process described by Tolbert and
Zucker (1996) informs the study. The process has the sequential stages of
habitualization, objectification and, sedimentation. It examines how various
actors- both central and peripheral, employ mechanisms of defining, theorizing
and, identity construction (Lawrence & Suddaby, 2006) to institutionalize
the associated exchanges within commercial surrogacy. Every mechanism is associated
with achieving legitimacy, cultural-cognitive (preconscious taken for granted
understanding), normative (relation with the social norms), and/or regulative
(submitting to rules and regulations by authorities) (Scott, 2001). In the
commercial surrogacy, actors are unequal in their socio-economic and power
positions. Thus, it problematizes the exchange relationships from the lens of
fairness, equity and distributive justice. It does so by taking recourse of the
Integrative Justice Model (IJM), an ethical marketing framework suggesting
normative dimensions to equitably engage with impoverished exchange partners.

We employed Grounded Theory (Charmaz, 2006, Glaser & Strauss, 1967,
Strauss & Corbin, 1998) approach with intensive interviews as the primary
data collection instrument. We conducted 29 interviews with various market
actors, mainly in Gujarat province, and some in Punjab province where
commercial surrogacy flourished early. Our study revealed 17 broader themes, a
level of patterned response in a data. Themes are ‘major strategies' applied by
the various actors to construct the ‘practice and processes' of commercial
surrogacy. These strategies are broadly classified into three mechanisms-
defining, theorizing and identity construction, to understand an
institutionalization of the commercial surrogacy.

In habitualization, the first stage of institutionalization, meanings of
surrogacy practice and processes are created by core actors i.e. surrogates and
clinics. The objective here is to minimize
negative cognitive frames and, define the process. It is accomplished by
employing the strategies of defining and theorizing. It is done to achieve
cultural-cognitive legitimacy. Created meanings are settled in the stage of
objectification by employing strategies of identity construction and theorizing
by clinics and some vocal surrogates. Surrogates also resort to ‘storying’ and
myth making to create positive narrations about surrogacy to achieve consensus
of all stakeholders and public about commercial surrogacy. It helps to achieve
the normative legitimacy to commercial surrogacy. The same mechanisms as in
objectification are employed in the stage of sedimentation to continue the
meanings of surrogacy practice and process. However, it is done by peripheral actors
like media. It aims at low resistance by advocacy groups and continuing
cultural support for the practice by public. Its objective is to achieve the
regulative legitimacy. However, some signs of fragmentation
(deinstitutionalization) are apparent in this stage.

Furthermore, we, based on the evidence, argue that the benefits and
burdens of exchange should be equitably distributed. Banning commercial
surrogacy is not going to resolve the issues; instead, it may vitiate it by
denying the fundamental rights to the multitude of stakeholders. In a society,
where an overwhelming population does not have a social safety net, and society
judge women for their ability to fulfill a normative expectation of begetting a
child, these types of exchanges are practically inevitable. Further, the
omnipresence of the market cannot be challenged rather ‘prototype’ of inclusive
markets need to be created. IJM is one of the possible perspectives to make
these markets ‘just' and ‘fair.' We further provide a case, using IJM in the
light of participant's narrative to engage with impoverished exchange partners
equitably.